In my first posting on the patient's perspective I emphasized the importance of the relationship between the clinician and patient. I also focused on what physicians should be doing. In this post, I would like to share one of my own experiences that demonstrates the reasoning behind why the patient's perspective as well as their family's perspective is the most important attribute. Even though this took place so many years ago, I remember it so well because of the way that the physician made me feel. I went to go see my my primary care physician with my parents when I was about 14 years old. Unfortunately, my primary physician was not there so I had to see his covering provider. I had not seen my period for a few months and I was concerned about this. As soon as we went into the room, the physician asked me if I was pregnant. I knew that I was not pregnant so I wanted to have all of the necessary tests performed in order to ensure that I was in good health. The physician did not believe me when I said that I was positive that I was not pregnant. The physician went on to explain to my parents the amount of teenagers that entered her office and were pregnant. After her speech, the physician came over to me and told me that it was not good to lie and wanted to know if I was pregnant.
Both of my parents were in the room with me so she asked if I wanted them to leave so that I could have the opportunity to tell the truth. It was extremely frustrating due to the fact that I did not know this physician and did not like the manner in which she handled the situation. At such a young age, I was having so many different thoughts. I was concerned with whether or not something was wrong with me and if I would be able to have children in the future. The physician ordered me to have a pregnancy test, but no other tests were ordered. After the pregnancy test came back negative we left. I went back when my primary care physician was back in the office. He explained that it was normal for a female's hormones to be out of balance, but still ordered some tests to ensure that everything was fine. After all of my results came back normal I felt much better. The physician took the time to explain everything to me and addressed all of my concerns. This is what should be done. The first physician that I went to go see did not take my feelings into consideration. She may have many children come into her office pregnant, but that does not mean that she should assume that all of her females patients are pregnant. She made me feel as if I was being attacked. Each patient should be treated on an individual basis. This happened such a long time ago, but I remember it because I did not appreciate the way she made me feel. When I go to the doctor's office, I want to be helped and leave feeling good about the interaction. A patient's perspective is essential, because this is the patient's body after all.
Monday, June 27, 2011
Sunday, June 26, 2011
Patient's Perspective
The perspective of the patient is by far the most important determinant as to whether an adverse event has occurred. Healthcare professionals have to take all of their actions into consideration when it comes to patient care. It is also helpful to see it from the patient's point of view. Healthcare professionals are "at home" whent they are at healthcare facilities. This is not always the case for patients. Some individuals fear having to go to the hosptial or doctor's office. Patients may also regard situations differently and judge their relative importance. For this reason it is extremely important for all clinicians involved in a particular patitent's care to explain the steps that are taking place to the patient. The patient is ultimately first and should be the center of all decisions that are being made. Therefore, it is appropriate to repsect the patient and build a relationship with the patient.
An example of this is that when an adverse action takes place, it would be possible that the healthcare professionals of a facility will try to hide the incident. This will only demonstrate dishonesty and the patient will perceive this behavior as a red flag that the facility cannot be trusted. Many patients who have filed malpractice lawsuits in order to be able to find out the facts surronding their care (Ransom, 2008). This is also the route that had to be taken in order for the patient and their family to recieve an apology. The cultural change that is definitely needed is that the patient and their family should be involved throughout the entire process (Ransom, 2008).
Working at a hospital, I have had various experiences that truly highlight why a patient's perspective is the essential aspect of whether or not an adverse event has taken place. The incidents that are reported to the Risk Management Department at the hospital mostly come from patients. For this reason, the patient's perspective matters. In order for the healthcare professionals to ensure a positive experience, this must be taken into account. The hospital exists for the sole purpose of providing quality care to the patients. For this reason, the patient's opinions and concerns should always be addressed. The necessary steps should always be taken to ensure that care is given that satisfies the patient and their family.
Reference:
Ransom, Elizabeth. (2008). The Healthcare Quality Book. Chicago, IL: Health Administration Press.
An example of this is that when an adverse action takes place, it would be possible that the healthcare professionals of a facility will try to hide the incident. This will only demonstrate dishonesty and the patient will perceive this behavior as a red flag that the facility cannot be trusted. Many patients who have filed malpractice lawsuits in order to be able to find out the facts surronding their care (Ransom, 2008). This is also the route that had to be taken in order for the patient and their family to recieve an apology. The cultural change that is definitely needed is that the patient and their family should be involved throughout the entire process (Ransom, 2008).
Working at a hospital, I have had various experiences that truly highlight why a patient's perspective is the essential aspect of whether or not an adverse event has taken place. The incidents that are reported to the Risk Management Department at the hospital mostly come from patients. For this reason, the patient's perspective matters. In order for the healthcare professionals to ensure a positive experience, this must be taken into account. The hospital exists for the sole purpose of providing quality care to the patients. For this reason, the patient's opinions and concerns should always be addressed. The necessary steps should always be taken to ensure that care is given that satisfies the patient and their family.
Reference:
Ransom, Elizabeth. (2008). The Healthcare Quality Book. Chicago, IL: Health Administration Press.
Monday, June 6, 2011
What Quality Means To Me (2nd Entry)
In my first entry I gave details into what I believe is care of the highest quality. I gave examples of when I was a patient and what made quality care. In this posting I would like to focus on what I am able to do in the corporate office to ensure the quality of care for patients. In my opinion, it is pertinent to address quality metrics at all levels of a healthcare organization. The type of policies and methods that are used in the corporate settings drastically affects patient care.
I am a Credentialing Specialist and the documentation that I process allows physicians to have privileges at a healthcare organization. I must do my due diligence to ensure that all the necessary documentation is verified through primary source methods before privileges are obtained. It is necessary to verify Medical School, Residency training, Fellowship training, Affiliations, Work History, peer references, all medical licenses and any time gaps. If there is any information that comes back on a verification and raises concerns, then it is my responsibility to address this with the applying physician. This information must also be brought up to the leadership team. There is no information that we take lightly. Even information that others would take as 'no big deal' must be addressed. It is extremly important to examine all professional aspects of a physician who is trying to obtain privileges at a healthcare facility. It is also important to verify all areas that a physician has practiced medicine at. It would be very unfortunate to grant a physician privileges and later find out that he had quality issues at a hospital in a different state. These issues can easily follow him to the new healthcare organization.
The quality that is put into the credentialing process is a key aspect in ensuring that the physicians who are working in healthcare facilities have the qualifications to be there. This is an important step in providing patients with high quality physicians. This will of course result in high quality care. All patients want to know that they are going to a facility that is equipped with physicians who are the best of the best. This includes specialized trainings and Board Certifications. Since I know that quality is what I look for whenever I am a patient, I put all of my efforts into credentialing each physician. This way I am equipping the healthcare organization with the great resource of physicians who will practice quality care.
I am a Credentialing Specialist and the documentation that I process allows physicians to have privileges at a healthcare organization. I must do my due diligence to ensure that all the necessary documentation is verified through primary source methods before privileges are obtained. It is necessary to verify Medical School, Residency training, Fellowship training, Affiliations, Work History, peer references, all medical licenses and any time gaps. If there is any information that comes back on a verification and raises concerns, then it is my responsibility to address this with the applying physician. This information must also be brought up to the leadership team. There is no information that we take lightly. Even information that others would take as 'no big deal' must be addressed. It is extremly important to examine all professional aspects of a physician who is trying to obtain privileges at a healthcare facility. It is also important to verify all areas that a physician has practiced medicine at. It would be very unfortunate to grant a physician privileges and later find out that he had quality issues at a hospital in a different state. These issues can easily follow him to the new healthcare organization.
The quality that is put into the credentialing process is a key aspect in ensuring that the physicians who are working in healthcare facilities have the qualifications to be there. This is an important step in providing patients with high quality physicians. This will of course result in high quality care. All patients want to know that they are going to a facility that is equipped with physicians who are the best of the best. This includes specialized trainings and Board Certifications. Since I know that quality is what I look for whenever I am a patient, I put all of my efforts into credentialing each physician. This way I am equipping the healthcare organization with the great resource of physicians who will practice quality care.
Wednesday, June 1, 2011
What Quality Means to Me!
Quality is seen as a complex term in which almost all patients will have a unique definition. Personally, I believe that quality care is going to give me the best outcome and make me overall happy. There are various aspects that come into play when it comes to making patient happy. Patients want healthcare that ties into theirlifestyle, fits their needs and preferences and of course does not cause harm. Patients want to feel safe and know that they are being put first. In order for facilities to ensure that this quality standard is met, it is pertinent that a relationship is formed between the patient and clinician (Ransom, 2008). Patients also want to go to the facilities that provide "better" care. For some patients better care is described as the facilities that have the most amenities and are able to provide the latest in technological support (Ransom, 2008). Another important aspect in defining the highest quality of care is that patients want to have a continuum of services. Patients need physical support as well as mental and emotional support. Of course, factors that are considered to be quality care can change throughout the years. Healthcare facilities must have systems in place to measure quality. The only way to ensure that the quality metrics are accurate is to evaluate them and make adjustments whenever it becomes necessary. This was the reports are leading to improvements in the care that is received.
I have two very different experiences that I have had as a patient. When I turned eighteen, I had to find a new primary care physician. I went to a physician that my friend recommended. Upon entering the Family Medicine physician's office, I was shocked. The office looked as if it had not been cleaned in months. The medical assistant who greeted me was warm and welcoming. However, I had already taken on a negative attitude due to the appearance of the office. I waited for about an hour and a half before I was called in to the back. The nurse did not explain to me the details of what my visit would be like. When the physician came in, he did not greet or introduce himself to me even though I was a new patient. The physician then proceeded to ask me detailed medical questions and began to giggle. I felt uncomfortable and unsure of what it had to do with my visit. I asked questions and they went unanswered. It was obivous that they physician was overwhelmed and could not handle the patient load. In an effort to improve quality the physician should not have scheduled so many patients by himself. Also, it may be a good idea to consider getting a partner if there is an increased need in the community. The physician order some blood work and a few tests at the lab. After a few weeks, I contacted the office in regards to my results. At first no one seemed to know what I was talking about. Finally, another person came on the phone and told me that the lab is usually unreliable when it comes to sending back the results and were not sure if they received it back. However, the lady said that if something was wrong at tha lab I would have heard back so there is no need to worry. What is wrong with this picture? If the results have not been sent to the physician for him to review, then there is no way to know whether there is a problem or not. I was frustrated and disappointed that this is the type of care that the community is receiving. This is an example of poor quality care.
On a more positive note, I had a wonderful experience when I went to Celebration Dental to have my wisdom teeth removed. During the consultation, I was able to meet the dentist who would be performing the procedure. He immediately built a rapport with me. My X-Rays were shown and discussed with me. All of my questions and concerns were thoroughly addressed. The day of the procedure also went very well. I was warmly greeted and the facility was clean. When I went into the procedure room, I could tell that it was well-kept and it did not scare me. The dental surgeon and the rest of the team encouraged and spoke to me until the anesthesia knocked me out. After the procedure, the team ensured that my family was in the room when I woke up. The dentist also came to check up on me. I felt comfortable and truly felt that the staff put me first. I was not even cranky that my face was swollen! The culture of customer service was apparent. The overall experience left me extremely satisfied.
Growing up, I have always been a patient and have gone to various facilities. I understand what it feels like to be in the patient's shoes. Now that I work in the health care field, I am better able to understand what it is that I need to do in order to provide patients with the best outcome. I understand when patients are unsure of what is the best decision and are confused. I also understand what will make them feel comfortable. Being able to relate to patients' feelings and showing compassion has always seemed to help them emotionally. Ultimately, with any quality initiative I believe that it is essential to put the Patient First in all decisions that are made.
Reference:
Ransom, Elizabeth. (2008). Health Care Quality Book. 2nd Edition. Chicago IL: Health Administration Press.
I have two very different experiences that I have had as a patient. When I turned eighteen, I had to find a new primary care physician. I went to a physician that my friend recommended. Upon entering the Family Medicine physician's office, I was shocked. The office looked as if it had not been cleaned in months. The medical assistant who greeted me was warm and welcoming. However, I had already taken on a negative attitude due to the appearance of the office. I waited for about an hour and a half before I was called in to the back. The nurse did not explain to me the details of what my visit would be like. When the physician came in, he did not greet or introduce himself to me even though I was a new patient. The physician then proceeded to ask me detailed medical questions and began to giggle. I felt uncomfortable and unsure of what it had to do with my visit. I asked questions and they went unanswered. It was obivous that they physician was overwhelmed and could not handle the patient load. In an effort to improve quality the physician should not have scheduled so many patients by himself. Also, it may be a good idea to consider getting a partner if there is an increased need in the community. The physician order some blood work and a few tests at the lab. After a few weeks, I contacted the office in regards to my results. At first no one seemed to know what I was talking about. Finally, another person came on the phone and told me that the lab is usually unreliable when it comes to sending back the results and were not sure if they received it back. However, the lady said that if something was wrong at tha lab I would have heard back so there is no need to worry. What is wrong with this picture? If the results have not been sent to the physician for him to review, then there is no way to know whether there is a problem or not. I was frustrated and disappointed that this is the type of care that the community is receiving. This is an example of poor quality care.
On a more positive note, I had a wonderful experience when I went to Celebration Dental to have my wisdom teeth removed. During the consultation, I was able to meet the dentist who would be performing the procedure. He immediately built a rapport with me. My X-Rays were shown and discussed with me. All of my questions and concerns were thoroughly addressed. The day of the procedure also went very well. I was warmly greeted and the facility was clean. When I went into the procedure room, I could tell that it was well-kept and it did not scare me. The dental surgeon and the rest of the team encouraged and spoke to me until the anesthesia knocked me out. After the procedure, the team ensured that my family was in the room when I woke up. The dentist also came to check up on me. I felt comfortable and truly felt that the staff put me first. I was not even cranky that my face was swollen! The culture of customer service was apparent. The overall experience left me extremely satisfied.
Growing up, I have always been a patient and have gone to various facilities. I understand what it feels like to be in the patient's shoes. Now that I work in the health care field, I am better able to understand what it is that I need to do in order to provide patients with the best outcome. I understand when patients are unsure of what is the best decision and are confused. I also understand what will make them feel comfortable. Being able to relate to patients' feelings and showing compassion has always seemed to help them emotionally. Ultimately, with any quality initiative I believe that it is essential to put the Patient First in all decisions that are made.
Reference:
Ransom, Elizabeth. (2008). Health Care Quality Book. 2nd Edition. Chicago IL: Health Administration Press.
Tuesday, November 24, 2009
Final Blog!!!
This past week I have been working on my blog log and paper. For this reason I have been reflecting on the course and my experience. The Infected Men's Panel, M&M Simulation, Thrush Simulation, Silverlake Life Movie and the book What Looks Like Crazy are just to name a few assignments that were very interesting. This has been a very hectic and fulfilling semester. I have learned so much and I am more aware of HIV before I enrolled in this course. I will take everything I learned in this course with me on my journey through life. My major is Health Services Administration and I plan to be apart of programs in order to promote HIV Prevention and I want to get involved in funding issues. The impact of HIV on the community is something that cannot be ignored. I can definitely say that this is one of the few classes I have taken that I have grown in. All of the assignments were important to me and was not just busy work. I can't believe that this is my final blog. The semester went by so fast!
Did You Know?
The HIV Prevention Srategic Plan has been extended through 2010 and its short term milestone is to increase the number of providers who routinely provide screening in health care settings. The HIV Prevention Leadership Summit is coming up in 2010 and I hope that the outcome is postitively seen throughout the community. I like that fact that there is a focus on routine screening. If it takes incentives from the insurance companies for physicians to want to recommend routine screening, then that is what needs to happen. Too many people are becoming infected at a fast rate and people are acting as if they do not care. This prevention method will ensure that people know their status and this will decrease the chances of them transmitting it to others. The HIV Prevention Leadership Summit will be a great way to spread awareness and encourage people to protect themselves and to go get tested.
Web: CDC. 2009. Retrieved on November 24, 2009 from, http://www.cdc.gov/hiv/resources/reports/psp/goal_objective.htm
Did You Know?
The HIV Prevention Srategic Plan has been extended through 2010 and its short term milestone is to increase the number of providers who routinely provide screening in health care settings. The HIV Prevention Leadership Summit is coming up in 2010 and I hope that the outcome is postitively seen throughout the community. I like that fact that there is a focus on routine screening. If it takes incentives from the insurance companies for physicians to want to recommend routine screening, then that is what needs to happen. Too many people are becoming infected at a fast rate and people are acting as if they do not care. This prevention method will ensure that people know their status and this will decrease the chances of them transmitting it to others. The HIV Prevention Leadership Summit will be a great way to spread awareness and encourage people to protect themselves and to go get tested.
Web: CDC. 2009. Retrieved on November 24, 2009 from, http://www.cdc.gov/hiv/resources/reports/psp/goal_objective.htm
Wednesday, November 18, 2009
More Prevention....
The QOTW was connected to my blog topic in a way because it focused on finding methods to educate individuals on HIV disease. This is pretty much what prevention is all about. If the current methods are not working, then we cannot continue to do the same thing with no results.
This past week I have been working on my blog log. I'm glad the due date was pushed back though so that I can give myself more time to get everything completed. Now that the holidays are coming up and I just finished the simulation I have been thinking about what it would be like on Thansgiving and Christmas. If I have not told the whole family about my status it would be extremely uncomfortable to take all nineteen pills without making it obivous. I am definitely glad that I left work early and attended the Men's Infected Panel today. I wish I was able to go to the Women's Infected Panel, because Teach said that both panels are different. Since I am a female I would have liked to be able to hear it from a female's point of view as well. I have a completely different outlook on the disease after listening to the panel. They were all full of life and inspire me to be a better person. I admire their strength and their ability to be proactive about their diagnosis.
Did You Know?
There is a project for community based organizations that uses social network strategies. This is an effort to reach persons who are at high risk for HIV infection. The Center for Multicultural Wellness and Prevention in Orlando is apart of the social network strategies. This program focuses on at risk Black and Hispanic young adults starting at the age of 18 in Orange, Osceola and Seminole counties. They enlist HIV positive individuals as recruiters. This person can counsel and provide education to those who test positive or negative. It is refreshing to know that Florida has this type of program, because we are number one in the nation for heterosexual transmission and the general rate of transmission in Orlando is increasing drastically. These types of programs are important in order to educate young adults. A person who has had to live with the disease is a great source of knowledge. I have never met a person who is HIV positive that openly shares it until I took this course. This class has provided me with a great deal of knowledge, but this type of knowledge should be taking place before senior year in college. The challenge that awaits us!
Web: CDC. 2009. Retrieved November 17, 2009 from, http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/factsheets/SNDP.htm
This past week I have been working on my blog log. I'm glad the due date was pushed back though so that I can give myself more time to get everything completed. Now that the holidays are coming up and I just finished the simulation I have been thinking about what it would be like on Thansgiving and Christmas. If I have not told the whole family about my status it would be extremely uncomfortable to take all nineteen pills without making it obivous. I am definitely glad that I left work early and attended the Men's Infected Panel today. I wish I was able to go to the Women's Infected Panel, because Teach said that both panels are different. Since I am a female I would have liked to be able to hear it from a female's point of view as well. I have a completely different outlook on the disease after listening to the panel. They were all full of life and inspire me to be a better person. I admire their strength and their ability to be proactive about their diagnosis.
Did You Know?
There is a project for community based organizations that uses social network strategies. This is an effort to reach persons who are at high risk for HIV infection. The Center for Multicultural Wellness and Prevention in Orlando is apart of the social network strategies. This program focuses on at risk Black and Hispanic young adults starting at the age of 18 in Orange, Osceola and Seminole counties. They enlist HIV positive individuals as recruiters. This person can counsel and provide education to those who test positive or negative. It is refreshing to know that Florida has this type of program, because we are number one in the nation for heterosexual transmission and the general rate of transmission in Orlando is increasing drastically. These types of programs are important in order to educate young adults. A person who has had to live with the disease is a great source of knowledge. I have never met a person who is HIV positive that openly shares it until I took this course. This class has provided me with a great deal of knowledge, but this type of knowledge should be taking place before senior year in college. The challenge that awaits us!
Web: CDC. 2009. Retrieved November 17, 2009 from, http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/factsheets/SNDP.htm
Wednesday, November 11, 2009
Prevention continued
I am so happy that the M&M Simulation is over!!!! I understand that HIV is no longer a death sentence, but I already know that I would have an extremely hard time accepting and dealing with the disease if I was HIV positive. I would have to get used to the routine of making pills apart of my day to day routine. It takes a lot of discipline, because I was messing up on my pill routine on the first day. The emotional aspect of it is also very challenging. When I told a few people I was pretending to be HIV positive for a class, their reaction was kind of rude. I can only imagine their reaction if I was really HIV positive. I would never want to share my status with certain people for this reason. The QOTW makes me think about what the world will be like 50 years from now. So many people predict that everyone will have chips planted inside of them in order for the government to track them. I do not want any type of device inserted into my body. I do not think that HIV positive individuals should be tracked due to their status. I do not think that this will decrease the number of HIV cases. The course is coming to an end, but I will definitely take the information I learned with me throughout life.
Did You Know?
Less than 40% of young people globally have correct basic knowledge on HIV. Only a third of HIV positive pregnant women receive antiretrovirals to prevent HIV transmission to their babies. Only a minority of the most at risk groups have access to HIV prevention programmes(UNAIDS, 2008). Can you see why this is a problem? For this reason new HIV prevention technologies has become the focus for the Joint United Nations Program on HIV/AIDS meeting in London. New HIV prevention technologies include vaccines, microbicides and other developing methods that could play a role in the transmission rate (UNAIDS, 2008). This will require global partnership among scientists, private sector, communities and the government (UNAIDS, 2008). I admire the hard work of the organization, but I am not very opptimistic about scientists finding a vaccine for HIV. I support all the research and I really hope that one is found, but I am not as positive about it as the organization is. My reason for this is due to the fact that there has never been a vaccine found for a virus. I look forward to learning much more about HIV from developing research.
Web: UNAIDS. 5 November 2008. Retrieved November 11, 2009 from, http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2008/20081105_Focus_new_HIV_prev_tech.asp
Did You Know?
Less than 40% of young people globally have correct basic knowledge on HIV. Only a third of HIV positive pregnant women receive antiretrovirals to prevent HIV transmission to their babies. Only a minority of the most at risk groups have access to HIV prevention programmes(UNAIDS, 2008). Can you see why this is a problem? For this reason new HIV prevention technologies has become the focus for the Joint United Nations Program on HIV/AIDS meeting in London. New HIV prevention technologies include vaccines, microbicides and other developing methods that could play a role in the transmission rate (UNAIDS, 2008). This will require global partnership among scientists, private sector, communities and the government (UNAIDS, 2008). I admire the hard work of the organization, but I am not very opptimistic about scientists finding a vaccine for HIV. I support all the research and I really hope that one is found, but I am not as positive about it as the organization is. My reason for this is due to the fact that there has never been a vaccine found for a virus. I look forward to learning much more about HIV from developing research.
Web: UNAIDS. 5 November 2008. Retrieved November 11, 2009 from, http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2008/20081105_Focus_new_HIV_prev_tech.asp
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